Drug levels if pregnant, on contraceptive pill and lamotrigine, intermittent compliance is suspected, toxicity is suspect or the patient is on phenytoin (in general, levels outside parameters have limited role in management).

A request for an EEG (fax 6173 0292) if the patient has not had one before, events are frequent, their nature is uncertain, it is many years since they have had one or they are seizure free for 10 years and seek a commercial driver's licence.

All referrals are triaged and allocated according to clinical guidelines as urgent or non-urgent. A written referral stated urgent does not guarantee urgent attention.

Additional information

Most patients with epilepsy don't require specialist review for assessment of fitness to drive, and most assessments can be completed by a general practitioner.

The guidelines are clear and are available in Assessing Fitness to Drive, 4th edition, produced by Austroads. This is available on the internet at www.austroads.com.au.

Specialist assessment is typically required for initial assessment for a commercial license, or when exceptional circumstances apply (i.e. if patient's condition or circumstances are not specifically covered by guidelines, or there is doubt about the patient's fitness to drive